Patient Financial Representative

Job Title: Patient Financial Representative

Position Description: Serves as primary contact to educate patients and community about financial assistance and charity care programs, healthcare insurance exchange, or alternate insurance programs as appropriate and provide price estimates/point of service payments. Perform access related duties but not limited to validating insurance eligibility/referrals and scheduling, obtain authorizations.

Reports to: Revenue Cycle Supervisor                                                    

MISSION

Provide strong and exceptional customer service skills and ability to follow policies regarding financial counseling, insurance verification and scheduling. Conducts all interactions in a manner that will result in positive patient experience and appropriate reimbursement for services. Works in partnership with other team members to provide quality service to proactively support efforts that ensure delivery of safe patient care and services. Ensure the patient’s confidentiality and integrity are maintained to the highest standards.

OUTCOMES

• Provide exceptional quality care to patients and their families with respect and dignity while providing feelings of safety and security during all types of interactions. 
• Interviews patients and/or family members to secure information concerning insurance coverage, eligibility, and qualification for various financial assistance programs and/or arranges payment plans.
• Calculate estimated patient responsibility to inform the patient and document in the data entry system and adhere to the Collections Policy to ensure patients are aware that payment is due at time of service. 
• Collect payment prior or on the date of service and be responsible for setting up payment arrangements.
• Maintains tracking of patients on schedule, ensuring that the correct insurance plan, eligibility and authorization information has been entered into data entry systems accurately along with documenting applicable notes or reviewing secure notes.
• Provides clinical information as needed, emphasizing medical justification for procedure/service to insurance companies for completion of pre-certification/authorization process.
• Acts as a liaison between clinical staff, patients, physicians, and insurance payor by informing patients of authorization/benefit delays/denials, answering questions, educating patients about their benefit, offering assistance, and relaying messages pertaining to authorization or benefits of procedure/service.
• Reschedule/cancel patients in the data entry system accordingly due to verification/authorization related issues.

COMPETENCIES

Job Related Competencies:

1. Ensures Accountability: Holding self and others accountable to meet commitments.
2. Action Oriented: Taking on new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm.
3. Manages Conflict: Handling conflict situations effectively, with a minimum noise lens.
4. Financial Acumen: Interpreting and applying understanding of key financial indicators to make better business decisions.
5. Interpersonal Savvy: Relating openly and comfortably with diverse groups of people.
6. Drive Results: Consistently achieving results, even under tough circumstances.

Cultural Competencies:

Advanced Values: 

1. People
   • Collaborates: Building partnerships and working collaboratively with others to meet shared objectives
2. Heart
   • Patient Focus: Building strong patient relationships and delivering patient centric solutions.
3. Service
   • Instills Trust: Gaining the confidence and trust of others through honesty, integrity, and authenticity.
4. Excellence
   • Cultivates Innovation: Creating new and better ways for the organization to be successful.

Behaviors:

1. Being Resilient: 
   • Rebounding from setbacks and adversity when facing demanding situations
2. Self-Development:
   • Actively seeking new ways to grow and be challenged using both formal and informal development challenges.
3. Optimizes Work Processes: 
   • Knowing the most effective and efficient processes to get things done, with a focus on continuous improvement.
4. Professional Communication:
   • Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences, while maintaining a professional appearance and tone.

QUALIFICATIONS

Basic Qualifications:

Education:

• High School Diploma or GED 

Previous, Job Relevant Work Experience:

• 2 years of experience in financial counseling, insurance verification, billing, equivalent externship, or access related position.
• Working knowledge of basic medical terminology.
•  Ability to work independently in a changing environment and manage stressful situations.
• Must be able to speak and write in a clear and concise manner to convey messages and ensure that the customer understands whether clinical or non-clinical.
• Proficient in Microsoft Word/Excel/Outlook, and insurance websites.
• Requires travel within Metro Atlanta as needed to cover ASC locations and attend mandatory meetings/training.  
• Demonstrate a high level of professional conduct with colleagues, superiors, and internal/external customers.